Knowledge on Mother-to-child Transmission of Hiv and Practices of Infant Feeding Among Hiv-infected Mothers Attending Antiretroviral Therapy Centers in Juba, South Sudan

Abstract

Background Exclusive breastfeeding for the first six months of infant’s life is recommended for HIV-infected mothers. Formula feeding which is the best alternative to breastfeeding may not be practical in the Republic of South Sudan. Objectives This study sought to assess knowledge on mother-to-child transmission of HIV and practices of infant feeding 0-6 months among HIV-infected mothers attending the Antiretroviral Therapy Centers in Juba, South Sudan. Methodology This was a cross-sectional study in which 304 HIV-infected mothers with children aged 6-18 months were interviewed between October and December 2016 using structured questionnaires. Key informant interviews and focus group discussions were also conducted. Quantitative data was analyzed using Statistics Package for Social Sciences software and descriptive statistics were presented in frequency tables and graphs. Chi-square test was used to test the presence of significant association between the variables, and multiple logistic regression analysis was used to identify which predictor variables have major effect on the dependent variable. Qualitative data from key informant interviews and focus group discussions was analyzed manually and the information obtained was used to supplement and interpret the findings of the quantitative data. Study findings Of the 304 HIV-infected mothers, 42.4% of them were aged between 20 to 29 years and 39.5% were aged between 30 to 39 years with mean age of 29.7 years. Half of the mothers were married 12 | P a g e and 52.3% had three or more children. The highest level of formal education attained by majority of the mothers (54.6%) was primary level. Most of the mothers (52.6%) were the breadwinners in their families, and 95.4% of them earned less than 50 US dollars per month. Only 40% of the HIV-infected mothers had good knowledge on mother-to-child transmission of HIV. Majority of the mothers (70.1%) practiced mixed feeding, 23.0% of them practiced exclusive breastfeeding, while 6.6% of them practiced exclusive formula feeding. The factors that were found to have significant effect on choice of infant feeding methods were: number of children (odds ratio = 0.303, 95% Confidence interval: 0.161-0.571, p = 0.001); religion (odds ratio = 5.488, 95% Confidence interval: 1.590-18.944, p = 0.007); and mothers’ participation in prevention of mother-to-child transmission of HIV program (odds ratio = 2.260, 95% Confidence interval: 1.251-4.084, p = 0.007). There was no relationship between maternal level of knowledge on mother-to-child transmission of HIV and their infant feeding practices (chi-square at 3 degree of freedom = 6.995, p = 0.072). Conclusions and Recommendations Knowledge on mother-to-child transmission of HIV, its prevention and infant feeding options in the context of HIV is low. However, maternal level of knowledge does not affect their infant feeding practices. Mixed feeding before six months of age is predominant among the HIV-infected mothers attending the antiretroviral therapy centers in Juba. It is therefore recommended that the HIV-infected mothers should receive adequate information from the counselors regarding mother-to-child transmission of HIV, and exclusive breastfeeding in the first six months of infant’s life should be promoted among them with emphasis on continuation of breastfeeding for at least one year or beyond to increase child survival.